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Scope Treatment of a Ureterocele in the Bladder

Maine rates for HCPCS 52301

A thin telescope is passed along the urine channel into the bladder, and a ureterocele — a balloon-like swelling at the end of the tube bringing urine down from the kidney — is cut open or destroyed so urine can drain freely. It is done entirely through the natural opening, with no external incision.

Rates data updated July 2026.

Facilitymedian $7,244 · 10th–90th $7,244$8,1280%20%40%90th$7,244Professionalmedian $380 · 10th–90th $302$5750%10%20%10th90th$380$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$8,128.31
Median
$8,128.31
Typical High
$8,128.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$371.54
Typical High
$426.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$426.58
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$407.38
Typical High
$630.96
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$389.05
Typical High
$645.65
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$371.54
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$416.87
Typical High
$724.44